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• W4252801844 abstract "Mahesh et al. are concerned that our results may lead clinicians to use the Flutter device as “stand-alone” therapy for cystic fibrosis (CF). They base their concern on the fact that our subjects continued their routine therapeutic regimen, including chest percussion and postural drainage (P/PD) or other airway mucus clearance therapies, during the study period. However, only three of the 17 subjects who completed our study claimed that they routinely performed mucus clearance of any kind before the study, and therefore only these three subjects continued this therapy during the study. Their results do not differ from those of the other 14 subjects who completed the study; elimination of these subjects from the analysis does not change the overall results. Although many of our patients use the Flutter device, not all use it as stand-alone therapy. Airway mucus clearance therapy should be individualized for each patient and may require the use of several techniques for optimal results. We disagree with Mahesh et al. in the interpretation of studies mentioned in references 2 and 3 cited in their letter, both of which were conducted at the same institution. In both studies, the Flutter technique was not performed as presently recommended. The second study was not even conducted on patients with CF. With regard to the effect of P/PD or the Flutter device on peripheral airways, the study cited by Mahesh et al. on the effect of P/PD (reference 5) was also not conducted on patients with CF, whereas preliminary evidence suggests that the Flutter device does improve peripheral airway function in patients with CF.1Schibler A Casaulta C Kraemer R Rationale of oscillatory breathing as chest physiotherapy performed by the Flutter in patients with cystic fibrosis (CF) [Abstract].Pediatr Pulmonol. 1992; : 301Google Scholar, 2Casaulta Aebischer C Frey U Schibler A Kraemer R Efficacy of chest physiotherapy (CPT) (PEP mask versus Flutter) in patients with cystic fibrosis (CF) [Abstract].Eur Respir J. 1993; 6: 0459Google Scholar We agree that keeping the airways as clear as possible is critical to the care of patients with CF. It is for this reason that many investigators are evaluating new mucus clearance techniques as potential therapies, and we should not deny our patients more effective therapies simply because they are new. The fact that Mahesh et al. found that many CF Centers are using the Flutter device in place of P/PD suggests that our conclusions on the efficacy of the device have been borne out by actual clinical use. 9/35/69592" @default.
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• W4252801844 date "1996-01-01" @default.
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• W4252801844 title "Reply to: Efficacy of the Flutter device for airway mucus clearance in patients with cystic fibrosis" @default.
• W4252801844 doi "https://doi.org/10.1016/s0022-3476(96)70461-4" @default.
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